Premature rupture of membranes (PROM), defined as spontaneous rupture of fetal membranes before the onset of uterine contractions, is one of the most common diagnostic dilemmas in contemporary obstetric practice. PROM can occur at any gestational age, and preterm PROM (PPROM, defined as PROM before 37 weeks) is responsible for 20% to 40% of preterm births. This may result in infections, fetal distress and preterm birth, responsible for perinatal morbidity and mortality, strong damage or disorders for the fetus. The treatment of PROM depends not only on the stage of pregnancy and on the fetus maturity but also on the risk of infection and fetal distress. It is thus crucial to be able to diagnose PROM with accuracy at an early stage in order to decrease the risks of complications.
Early and accurate diagnosis of PROM would allow for gestational age-specific obstetric interventions designed to optimize perinatal outcome and minimize serious complications such as cord prolapse, preterm delivery, fetal distress and infectious morbidity (chorioamnionitis, neonatal sepsis). Conversely, a false-positive diagnosis of PROM may lead to unnecessary obstetric interventions, including hospitalization, administration of antibiotics and corticosteroids, and even induction of labor. Therefore, the correct and timely diagnosis of this disorder is of critical importance to the clinician because PROM and PPROM may be associated with serious maternal and neonatal consequences.